Improving the detection and treatment of depression in Australians with multiple sclerosis: A qualitative analysis

Assunta Hunter; Claudia H Marck; Ernest Butler; Michelle Allan; Karen-Leigh Edward; Andrew Giles; Jayashri Kulkarni; Deepa Rajendran; Sally Shaw; Lisa B Grech

doi:10.1016/j.msard.2021.103290

Improving the detection and treatment of depression in Australians with multiple sclerosis: A qualitative analysis

Mult Scler Relat Disord. 2021 Nov:56:103290. doi: 10.1016/j.msard.2021.103290. Epub 2021 Sep 28.

Authors

Affiliations

¹ Disability and Health Unit, Centre for Health Equity, the Melbourne School of Population and Global Health, the University of Melbourne, Parkville, Australia.
² Department of Neurology, Monash Medical Centre, Monash Health, Clayton, Australia; Department of Neurology, Frankston Hospital, Peninsula Health, Frankston, Australia; Medicine Monash Health, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Frankston Neurology, Frankston, Australia.
³ Her Heart Limited, Melbourne, Australia; Department of Health Sciences, Swinburne University, Melbourne, Australia.
⁴ MS Australia, North Sydney, Australia.
⁵ The Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Monash University, Australia.
⁶ Medicine Monash Health, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Frankston Neurology, Frankston, Australia.
⁷ Focussed Health Psychology, Blackburn, Australia.
⁸ Medicine Monash Health, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Department of Health Sciences, Swinburne University, Melbourne, Australia; Melbourne School of Psychological Sciences, the University of Melbourne, Parkville, Australia. Electronic address: lisa.grech@monash.edu.

PMID: 34614457
DOI: 10.1016/j.msard.2021.103290

Abstract

Background: Depression is common in people with multiple sclerosis (MS), yet often goes undetected, untreated or undertreated.

Objective: This qualitative research explored current practices, barriers and facilitators for detection and treatment of depression in Australians with MS.

Methods: Participants were 26 people with MS recruited through social media. Participants completed the Centre for Epidemiological Studies Depression-Revised (CESD-R) scale and in-depth telephone or video interviews. Interviews were analysed using framework analysis.

Results: Scores measured on the CESD-R proposed 73% of participants were experiencing severe depression symptoms. Participants reported that depression is not regularly and formally assessed through MS healthcare services and they are offered limited information about depression in MS. Barriers to mental health support included recognition of depression, resistance to treatment and limitations of collaborative support between general practitioners and MS healthcare services. Participants expressed a need for open conversations and information about depression during neurology consultations.

Conclusion: Based on our findings, improved detection and treatment of depression in people with MS requires: 1) better provision of information about depression for people with MS through healthcare services and community organisations; 2) regular screening and assessment; 3) better healthcare services collaboration to improve management.

Keywords: Depression; Detection; Healthcare services; Multiple sclerosis; Neurology; Treatment.

MeSH terms

Australia / epidemiology
Depression / diagnosis
Depression / epidemiology
Depression / therapy
Humans
Mental Health
Multiple Sclerosis* / complications
Multiple Sclerosis* / diagnosis
Multiple Sclerosis* / epidemiology
Qualitative Research